Читать книгу The Interpretation of Dreams - Sigmund Freud, Йоханнес Вильгельм Йенсен - Страница 6

The hall—many guests, whom we are receiving.

We were living this summer at the Bellevue, in an isolated house on one of the hills which lie close to the Kahlenberg. This house was once intended as a place of amusement, and on this account has unusually high, hall-like rooms. The dream also occurred at the Bellevue, a few days before the birthday of my wife. During the day, my wife had expressed the expectation that several friends, among them Irma, would come to us as guests for her birthday. My dream, then, anticipates this situation: It is the birthday of my wife, and many people, among them Irma, are received by us as guests in the great hall of the Bellevue.

I reproach Irma for not having accepted the solution. I say: "If you still have pains, it is your own fault."

I might have said this also, or did say it, while awake. At that time I had the opinion (recognised later to be incorrect) that my task was limited to informing patients of the hidden meaning of their symptoms. Whether they then accepted or did not accept the solution upon which success depended—for that I was not responsible. I am thankful to this error, which fortunately has now been overcome, for making life easier for me at a time when, with all my unavoidable ignorance, I was to produce successful cures. But I see in the speech which I make to Irma in the dream, that above all things I do not want to be to blame for the pains which she still feels. If it is Irma's own fault, it cannot be mine. Should the purpose of the dream be looked for in this quarter?

Irma's complaints; pains in the neck, abdomen, and stomach; she is drawn together.

Pains in the stomach belonged to the symptom-complex of my patient, but they were not very prominent; she complained rather of sensations of nausea and disgust. Pains in the neck and abdomen and constriction of the throat hardly played a part in her case. I wonder why I decided upon this choice of symptoms, nor can I for the moment find the reason.

She looks pale and bloated.

My patient was always ruddy. I suspect that another person is here being substituted for her.

I am frightened at the thought that I must have overlooked some organic affection.

This, as the reader will readily believe, is a constant fear with the specialist, who sees neurotics almost exclusively, and who is accustomed to ascribe so many manifestations, which other physicians treat as organic, to hysteria. On the other hand, I am haunted by a faint doubt—I know not whence it comes—as to whether my fear is altogether honest. If Irma's pains are indeed of organic origin, I am not bound to cure them. My treatment, of course, removes only hysterical pains. It seems to me, in fact, that I wish to find an error in the diagnosis; in that case the reproach of being unsuccessful would be removed.

I take her to the window in order to look into her throat. She resists a little, like a woman who has false teeth. I think she does not need them anyway.

I had never had occasion to inspect Irma's aural cavity. The incident in the dream reminds me of an examination, made some time before, of a governess who at first gave an impression of youthful beauty, but who upon opening her mouth took certain measures for concealing her teeth. Other memories of medical examinations and of little secrets which are discovered by them, unpleasantly for both examiner and examined, connect themselves with this case. "She does not need them anyway," is at first perhaps a compliment for Irma; but I suspect a different meaning. In careful analysis one feels whether or not the "background thoughts" which are to be expected have been exhausted. The way in which Irma stands at the window suddenly reminds me of another experience. Irma possesses an intimate woman friend, of whom I think very highly. One evening on paying her a visit I found her in the position at the window reproduced in the dream, and her physician, the same Dr. M., declared that she had a diphtheritic membrane. The person of Dr. M. and the membrane return in the course of the dream. Now it occurs to me that during the last few months, I have been given every reason to suppose that this lady is also hysterical. Yes, Irma herself has betrayed this to me. But what do I know about her condition? Only the one thing, that like Irma she suffers from hysterical choking in dreams. Thus in the dream I have replaced my patient by her friend. Now I remember that I have often trifled with the expectation that this lady might likewise engage me to relieve her of her symptoms. But even at the time I thought it improbable, for she is of a very shy nature. She resists, as the dream shows. Another explanation might be that she does not need it; in fact, until now she has shown herself strong enough to master her condition without outside help. Now only a few features remain, which I can assign neither to Irma nor to her friend: Pale, bloated, false teeth. The false teeth lead me to the governess; I now feel inclined to be satisfied with bad teeth. Then another person, to whom these features may allude, occurs to me. She is not my patient, and I do not wish her to be my patient, for I have noticed that she is not at her ease with me, and I do not consider her a docile patient. She is generally pale, and once, when she had a particularly good spell, she was bloated. I have thus compared my patient Irma with two others, who would likewise resist treatment. What can it mean that I have exchanged her for her friend in the dream? Perhaps that I wish to exchange her; either the other one arouses in me stronger sympathies or I have a higher opinion of her intelligence. For I consider Irma foolish because she does not accept my solution. The other one would be more sensible, and would thus be more likely to yield. The mouth then really opens without difficulty; she would tell more than Irma.

What I see in the throat; a white spot and scabby nostrils.

The white spot recalls diphtheria, and thus Irma's friend, but besides this it recalls the grave illness of my eldest daughter two years before and all the anxiety of that unfortunate time. The scab on the nostrils reminds me of a concern about my own health. At that time I often used cocaine in order to suppress annoying swellings in the nose, and had heard a few days before that a lady patient who did likewise had contracted an extensive necrosis of the nasal mucous membrane. The recommendation of cocaine, which I had made in 1885, had also brought grave reproaches upon me. A dear friend, already dead in 1895, had hastened his end through the misuse of this remedy.

I quickly call Dr. M., who repeats the examination.

This would simply correspond to the position which M. occupied among us. But the word "quickly" is striking enough to demand a special explanation. It reminds me of a sad medical experience. By the continued prescription of a remedy (sulfonal) which was still at that time considered harmless, I had once caused the severe intoxication of a woman patient, and I had turned in great haste to an older, more experienced colleague for assistance. The fact that I really had this case in mind is confirmed by an accessory circumstance. The patient, who succumbed to the intoxication, bore the same name as my eldest daughter. I had never thought of this until now; now it seems to me almost like a retribution of fate—as though I ought to continue the replacement of the persons here in another sense; this Matilda for that Matilda; an eye for an eye, a tooth for a tooth. It is as though I were seeking every opportunity to reproach myself with lack of medical conscientiousness.

Dr. M. is pale, without a beard on his chin, and he limps.

Of this so much is correct, that his unhealthy appearance often awakens the concern of his friends. The other two characteristics must belong to another person. A brother living abroad occurs to me, who wears his chin clean-shaven, and to whom, if I remember aright, M. of the dream on the whole bears some resemblance. About him the news arrived some days before that he was lame on account of an arthritic disease in the hip. There must be a reason why I fuse the two persons into one in the dream. I remember that in fact I was on bad terms with both of them for similar reasons. Both of them had rejected a certain proposal which I had recently made to them.

My friend Otto is now standing next to the sick woman, and my friend Leopold examines her and calls attention to a dulness on the left below.

My friend Leopold is also a physician, a relative of Otto. Since the two practise the same specialty, fate has made them competitors, who are continually being compared with each other. Both of them assisted me for years, while I was still directing a public dispensary for nervous children. Scenes like the one reproduced in the dream have often taken place there. While I was debating with Otto about the diagnosis of a case, Leopold had examined the child anew and had made an unexpected contribution towards the decision. For there was a difference of character between the two similar to that between Inspector Brassig and his friend Charles. The one was distinguished for his brightness, the other was slow, thoughtful, but thorough. If I contrast Otto and the careful Leopold in the dream, I do it, apparently, in order to extol Leopold. It is a comparison similar to the one above between the disobedient patient Irma and her friend who is thought to be more sensible. I now become aware of one of the tracks along which the thought association of the dream progresses; from the sick child to the children's asylum. The dulness to the left, below, recalls a certain case corresponding to it, in every detail in which Leopold astonished me by his thoroughness. Besides this, I have a notion of something like a metastatic affection, but it might rather be a reference to the lady patient whom I should like to have instead of Irma. For this lady, as far as I can gather, resembles a woman suffering from tuberculosis.

An infiltrated portion of skin on the left shoulder.

I see at once that this is my own rheumatism of the shoulder, which I always feel when I have remained awake until late at night. The turn of phrase in the dream also sounds ambiguous; something which I feel... in spite of the dress. "Feel on my own body" is intended. Moreover, I am struck with the unusual sound of the term "infiltrated portion of skin." "An infiltration behind on the upper left" is what we are accustomed to; this would refer to the lung, and thus again to tuberculosis patients.

In spite of the dress.

This, to be sure, is only an interpolation. We, of course, examine the children in the clinic undressed; it is some sort of contradiction to the manner in which grown-up female patients must be examined. The story used to be told of a prominent clinician that he always examined his patients physically only through the clothes. The rest is obscure to me; I have, frankly, no inclination to follow the matter further.

Dr. M. says: "It is an infection, but it does not matter. Dysentery will develop, and the poison will be excreted.

This at first seems ridiculous to me; still it must be carefully analysed like everything else. Observed more closely, it seems, however, to have a kind of meaning. What I had found in the patient was local diphtheritis. I remember the discussion about diphtheritis and diphtheria at the time of my daughter's illness. The latter is the general infection which proceeds from local diphtheritis. Leopold proves the existence of such general infection by means of the dulness, which thus suggests a metastatic lesion. I believe, however, that just this kind of metastasis does not occur in the case of diphtheria. It rather recalls pyæmia.

It does not matter, is a consolation. I believe it fits in as follows: The last part of the dream has yielded a content to the effect that the pains of the patient are the result of a serious organic affection. I begin to suspect that with this I am only trying to shift the blame from myself. Psychic treatment cannot be held responsible for the continued presence of diphtheritic affection. But now, in turn, I am disturbed at inventing such serious suffering for Irma for the sole purpose of exculpating myself. It seems cruel. I need (accordingly) the assurance that the result will be happy, and it does not seem ill-advised that I should put the words of consolation into the mouth of Dr. M. But here I consider myself superior to the dream, a fact which needs explanation.

But why is this consolation so nonsensical?

Dysentery:

Some sort of far-fetched theoretical notion that pathological material may be removed through the intestines. Am I in this way trying to make fun of Dr. M.'s great store of far-fetched explanations, his habit of finding curious pathological relationships? Dysentery suggests something else. A few months ago I had in charge a young man suffering from remarkable pains during evacuation of the bowels, a case which colleagues had treated as "anæmia with malnutrition." I realised that it was a question of hysteria; I was unwilling to use my psychotherapy on him, and sent him off on a sea voyage. Now a few days before I had received a despairing letter from him from Egypt, saying that while there he had suffered a new attack, which the physician had declared to be dysentery. I suspect, indeed, that the diagnosis was only an error of my ignorant colleague, who allows hysteria to make a fool of him; but still I cannot avoid reproaching myself for putting the invalid in a position where he might contract an organic affection of the bowels in addition to his hysteria. Furthermore, dysentery sounds like diphtheria, a word which does not occur in the dream.

Indeed it must be that, with the consoling prognosis: "Dysentery will develop, &c.," I am making fun of Dr. M., for I recollect that years ago he once jokingly told a very similar story of another colleague. He had been called to consult with this colleague in the case of a woman who was very seriously ill and had felt obliged to confront the other physician, who seemed very hopeful, with the fact that he found albumen in the patient's urine. The colleague, however, did not let this worry him, but answered calmly: "That does not matter, doctor; the albumen will without doubt be excreted." Thus I can no longer doubt that derision for those colleagues who are ignorant of hysteria is contained in this part of the dream. As though in confirmation, this question now arises in my mind: "Does Dr. M. know that the symptoms of his patient, of our friend Irma, which give cause for fearing tuberculosis, are also based on hysteria? Has he recognised this hysteria, or has he stupidly ignored it?"

But what can be my motive in treating this friend so badly? This is very simple: Dr. M. agrees with my solution as little as Irma herself. I have thus already in this dream taken revenge on two persons, on Irma in the words, "If you still have pains, it is your own fault," and on Dr. M. in the wording of the nonsensical consolation which has been put into his mouth.

We have immediate knowledge of the origin of the infection.

This immediate knowledge in the dream is very remarkable. Just before we did not know it, since the infection was first demonstrated by Leopold.

My friend Otto has recently given her an injection when she felt ill.

Otto had actually related that in the short time of his visit to Irma's family, he had been called to a neighbouring hotel in order to give an injection to some one who fell suddenly ill. Injections again recall the unfortunate friend who has poisoned himself with cocaine. I had recommended the remedy to him merely for internal use during the withdrawal of morphine, but he once gave himself injections of cocaine.

With a propyl preparation... propyls... propionic acid.

How did this ever occur to me? On the same evening on which I had written part of the history of the disease before having the dream, my wife opened a bottle of cordial labelled "Ananas," (which was a present from our friend Otto. For he had a habit of making presents on every possible occasion; I hope he will some day be cured of this by a wife). Such a smell of fusel oil arose from this cordial that I refused to taste it. My wife observed: "We will give this bottle to the servants," and I, still more prudent, forbade it, with the philanthropic remark: "They mustn't be poisoned either." The smell of fusel oil (amyl...) has now apparently awakened in my memory the whole series, propyl, methyl, &c., which has furnished the propyl preparation of the dream. In this, it is true, I have employed a substitution; I have dreamt of propyl, after smelling amyl, but substitutions of this kind are perhaps permissible, especially in organic chemistry.

Trimethylamin. I see the chemical formula of this substance in the dream, a fact which probably gives evidence of a great effort on the part of my memory, and, moreover, the formula is printed in heavy type, as if to lay special stress upon something of particular importance, as distinguished from the context. To what does this trimethylamin lead, which has been so forcibly called to my attention? It leads to a conversation with another friend who for years has known all my germinating activities, as I have his. At that time he had just informed me of some of his ideas about sexual chemistry, and had mentioned, among others, that he thought he recognised in trimethylamin one of the products of sexual metabolism. This substance thus leads me to sexuality, to that factor which I credit with the greatest significance for the origin of the nervous affections which I attempt to cure. My patient Irma is a young widow; if I am anxious to excuse the failure of her cure, I suppose I shall best do so by referring to this condition, which her admirers would be glad to change. How remarkably, too, such a dream is fashioned! The other woman, whom I take as my patient in the dream instead of Irma, is also a young widow.

I suspect why the formula of trimethylamin has made itself so prominent in the dream. So many important things are gathered up in this one word: Trimethylamin is not only an allusion to the overpowering factor of sexuality, but also to a person whose sympathy I remember with satisfaction when I feel myself forsaken in my opinions. Should not this friend, who plays such a large part in my life, occur again in the chain of thoughts of the dream? Of course, he must; he is particularly acquainted with the results which proceed from affections of the nose and its adjacent cavities, and has revealed to science several highly remarkable relations of the turbinated bones to the female sexual organs (the three curly formations in Irma's throat). I have had Irma examined by him to see whether the pains in her stomach might be of nasal origin. But he himself suffers from suppurative rhinitis, which worries him, and to this perhaps there is an allusion in pyæmia, which hovers before me in the metastases of the dream.

Such injections are not made so rashly. Here the reproach of carelessness is hurled directly at my friend Otto. I am under the impression that I had some thought of this sort in the afternoon, when he seemed to indicate his siding against me by word and look. It was perhaps: "How easily he can be influenced; how carelessly he pronounces judgment." Furthermore, the above sentence again points to my deceased friend, who so lightly took refuge in cocaine injections. As I have said, I had not intended injections of the remedy at all. I see that in reproaching Otto I again touch upon the story of the unfortunate Matilda, from which arises the same reproach against me. Obviously I am here collecting examples of my own conscientiousness, but also of the opposite.

Probably also the syringe was not clean. Another reproach directed at Otto, but originating elsewhere. The day before I happened to meet the son of a lady eighty-two years of age whom I am obliged to give daily two injections of morphine. At present she is in the country, and I have heard that she is suffering from an inflammation of the veins. I immediately thought that it was a case of infection due to contamination from the syringe. It is my pride that in two years I have not given her a single infection; I am constantly concerned, of course, to see that the syringe is perfectly clean. For I am conscientious. From the inflammation of the veins, I return to my wife, who had suffered from emboli during a period of pregnancy, and now three related situations come to the surface in my memory, involving my wife, Irma, and the deceased Matilda, the identity of which three persons plainly justifies my putting them in one another's place.

I have now completed the interpretation of the dream. In the course of this interpretation I have taken great pains to get possession of all the notions to which a comparison between the dream content and the dream thoughts hidden behind it must have given rise. Meanwhile, the "meaning" of the dream has dawned upon me. I have become conscious of a purpose which is realised by means of the dream, and which must have been the motive for dreaming. The dream fulfils several wishes, which have been actuated in me by the events of the preceding evening (Otto's news, and the writing down of the history of the disease). For the result of the dream is that I am not to blame for the suffering which Irma still has, and that Otto is to blame for it. Now Otto has made me angry by his remark about Irma's imperfect cure; the dream avenges me upon him by turning the reproach back upon himself. The dream acquits me of responsibility for Irma's condition by referring it to other causes, which indeed furnish a great number of explanations. The dream represents a certain condition of affairs as I should wish it to be; the content of the dream is thus the fulfilment of a wish; its motive is a wish.

This much is apparent at first sight. But many things in the details of the dream become intelligible when regarded from the point of view of wish-fulfilment. I take revenge on Otto, not only for hastily taking part against me, in that I accuse him of a careless medical operation (the injection), but I am also avenged on him for the bad cordial which smells like fusel oil, and I find an expression in the dream which unites both reproaches; the injection with a preparation of propyl. Still I am not satisfied, but continue my revenge by comparing him to his more reliable competitor. I seem to say by this: "I like him better than you." But Otto is not the only one who must feel the force of my anger. I take revenge on the disobedient patient by exchanging her for a more sensible, more docile one. Nor do I leave the contradiction of Dr. M. unnoticed, but express my opinion of him in an obvious allusion, to the effect that his relation to the question is that of an ignoramus ("dysentery will develop," &c.).

It seems to me, indeed, as though I were appealing from him to some one better informed (my friend, who has told me about trimethylamin); just as I have turned from Irma to her friend, I turn from Otto to Leopold. Rid me of these three persons, replace them by three others of my own choice, and I shall be released from the reproaches which I do not wish to have deserved! The unreasonableness itself of these reproaches is proved to me in the dream in the most elaborate way. Irma's pains are not charged to me, because she herself is to blame for them, in that she refuses to accept my solution. Irma's pains are none of my business, for they are of an organic nature, quite impossible to be healed by a psychic cure. Irma's sufferings are satisfactorily explained by her widowhood (trimethylamin!); a fact which, of course, I cannot alter. Irma's illness has been caused by an incautious injection on the part of Otto, with an ill-suited substance—in a way I should never have made an injection. Irma's suffering is the result of an injection made with an unclean syringe, just like the inflammation of the veins in my old lady, while I never do any such mischief with my injections. I am aware, indeed, that these explanations of Irma's illness, which unite in acquitting me, do not agree with one another; they even exclude one another. The whole pleading—this dream is nothing else—recalls vividly the defensive argument of a man who was accused by his neighbour of having returned a kettle to him in a damaged condition. In the first place, he said, he had returned the kettle undamaged; in the second, it already had holes in it when he borrowed it; and thirdly, he had never borrowed the kettle from his neighbour at all. But so much the better; if even one of these three methods of defence is recognised as valid, the man must be acquitted.

Still other subjects mingle in the dream, whose relation to my release from responsibility for Irma's illness is not so transparent: the illness of my daughter and that of a patient of the same name, the harmfulness of cocaine, the illness of my patient travelling in Egypt, concern about the health of my wife, my brother, of Dr. M., my own bodily troubles, and concern about the absent friend who is suffering from suppurative rhinitis. But if I keep all these things in view, they combine into a single train of thought, labelled perhaps: Concern for the health of myself and others—professional conscientiousness. I recall an undefined disagreeable sensation as Otto brought me the news of Irma's condition. I should like to note finally the expression of this fleeting sensation, which is part of the train of thought that is mingled into the dream. It is as though Otto had said to me: "You do not take your physician's duties seriously enough, you are not conscientious, do not keep your promises." Thereupon this train of thought placed itself at my service in order that I might exhibit proof of the high degree in which I am conscientious, how intimately I am concerned with the health of my relatives, friends, and patients. Curiously enough, there are also in this thought material some painful memories, which correspond rather to the blame attributed to Otto than to the accusation against me. The material has the appearance of being impartial, but the connection between this broader material, upon which the dream depends, and the more limited theme of the dream which gives rise to the wish to be innocent of Irma's illness, is nevertheless unmistakable.

I do not wish to claim that I have revealed the meaning of the dream entirely, or that the interpretation is flawless.

I could still spend much time upon it; I could draw further explanations from it, and bring up new problems which it bids us consider. I even know the points from which further thought associations might be traced; but such considerations as are connected with every dream of one's own restrain me from the work of interpretation. Whoever is ready to condemn such reserve, may himself try to be more straightforward than I. I am content with the discovery which has been just made. If the method of dream interpretation here indicated is followed, it will be found that the dream really has meaning, and is by no means the expression of fragmentary brain activity, which the authors would have us believe. When the work of interpretation has been completed the dream may be recognised as the fulfilment of a wish.